The Countess of Chester Hospital

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were supported and treated with compassion and respect; and involved as partners in their care.

Staff demonstrated compassion and sensitivity even in challenging and busy environments. Patients felt involved in decisions, with staff using interpreters and communication aids to meet diverse needs. Cultural needs were also considered. Staff responded promptly when people showed signs of discomfort or distress despite compliance for pain assessment audits being below the trust standards.

People using the service felt their dignity had been preserved but told us the environment made it more challenging. We saw examples where people’s dignity was not always fully considered. The service took action to address and improve this following our assessment.

We have not awarded this service a score for Caring.

Find out about when we will not publish a key question score and what we look at when we assess Caring.

We scored the service as 3. The evidence showed a good standard. The service always treated people with kindness, empathy, and compassion. Staff treated colleagues from other organisations with kindness and respect.

Following our previous assessment in February 2025, compassion and civility training had been developed and delivered by practice development staff. The training had been positively evaluated and there were plans to roll this out across the trust. The training incorporated scenario-based exercises and focused on compassion fatigue. Evaluation of the training showed it had a positive impact on staff. One staff member said: “it’s opening people’s eyes to the way we can be perceived by patients. How it can feel to be a patient in the busy department. Small changes can make a big impact on care.”

We observed positive examples of kind and compassionate interactions between staff in all roles and with patients. Patients feedback was mostly positive, and one patient told us their experience had improved since previous visits, they could see a change in the service.

Staff working in the service worked collaboratively, and demonstrated kindness, towards colleagues from liaison psychiatry and ambulance services which were provided by other NHS trusts.

Ongoing building work in the department had reduced the capacity of the waiting room, which meant it became very crowded at times. We observed that during the booking in process when people arrived in the department sensitive information could be overheard by others in the waiting room.

Most people we spoke to using the service felt their privacy and dignity had been considered but the lack of space due to building work and the volume of people in the department made it more difficult. People told us staff were friendly and compassionate.

We scored the service as 3. The evidence showed a good standard. The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences.

Staff demonstrated an understanding of diverse patient needs and told us about face to face or telephone interpretation services that could be used. This benefited individuals whose first language was not English or those requiring British Sign Language. Staff talked to patients in a way they could understand, using communication aids where necessary.

Feedback from people collected by the service as part of the ward accreditation schemes showed 100% of people asked in ED between July 2025 and October 2025 felt their expectations had been met with regards to personal, cultural, social, and religious needs. Most people knew how to give feedback or raise concerns about their care.

Patients we spoke to told us they felt their needs were understood and considered by staff.

We scored the service as 3. The evidence showed a good standard. The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Feedback from people collected by the service as part of the ward accreditation schemes showed 100% of people asked felt their choice had been considered. However, patient involvement was not always documented in clinical records. People understood they could access their care records if they wished.

People using the service told us they had been involved in planning their care and understood the plan for their treatment. However not everyone had been informed about the reasons they had been moved around the department.

Adults, children and families told us they felt able to ask nurses and doctors questions regarding their care and treatment, and staff took time to answer any questions they had.

We scored the service as 2. The evidence showed some shortfalls. The service did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress. People’s privacy and dignity was not always preserved.

We observed a patient receiving emergency care in resus. Due to the layout of the area, and the number of staff involved, patients and visitors in the neighbouring bed space were able to hear personal and distressing information about the emergency. Staff had to be prompted to use the curtains to maintain patient dignity. Patients in that area told us it was distressing to be exposed to this. Following our assessment the ability to maintain confidentiality in the resuscitation area has been added to the service risk register.

We observed nursing handovers and in one area of ED multiple patients’ information was being discussed at the bedside of one patient. Confidentiality was not considered in this process; we escalated this and following our assessment changes have been made to the handover process which is now completed on an individual patient basis.

We observed drinks and snacks being provided frequently by staff whilst we were in the ED. We observed that patients who had been in the ED department for a long time were transferred from a trolley to a hospital bed to improve comfort and protect skin integrity.

Most people we spoke to using the service told us staff responded quickly when they were in pain or distressed. People we spoke to using the service told us they felt safe.

Staff at all levels of seniority, across all professions demonstrated caring and attentive attitudes towards patients. Feedback from people collected by the service as part of ward accreditation schemes showed people felt their needs had been met.

We scored the service as 3. The evidence showed a good standard. The service cared about and promoted the wellbeing of their staff.

Nursing leaders met regularly to discuss staff wellbeing and acknowledged the impact pressure and demand within the service could have on staff. Leaders were proactive in providing wellbeing support and hoped to arrange events specific to the UEC staff in future. Senior leaders held regular listening events and drop-in sessions.

Staff had access to a range of wellbeing services delivered through the wellbeing team and wellbeing hubs. Physical activity was also promoted through running events and staff wellbeing movement programmes.

Wellbeing hubs provided 24/7 access to information, resources and rest spaces. Specialist support was also available, including access to an alcohol support practitioner, support following miscarriage or baby loss, and referral pathways to partner organisations. Newly qualified staff received additional wellbeing support through the preceptorship programme.

Most staff we spoke to as part of the inspection enjoyed working in the service. Many said they had seen an improvement in the culture of the ED since our last assessment.

Medical staff told us their access to psychology support had recently been reduced which had negatively impacted on wellbeing. They were not always able to access trust wide services because of pressure within the service or their working hours.

The 2024 staff survey result for the category of “we are safe and healthy” for the urgent care division scored on average 5.3 out of 10. This was slightly below the national benchmark average of 6.1 out of 10 and below the trust wide result which was 5.8 out of 10. The result for the category of “morale” was 5.22 out of 10, this was lower than the trust wide result. Leaders had an action plan in place to promote improvement in each category.